Chapter 9 Alcoholic Beverages

Overview

The consumption of alcohol can have beneficial or harmful effects depending
on the amount consumed, age and other characteristics of the person consuming
the alcohol, and specifics of the situation. In 2002, 55 percent of U.S.
adults were current drinkers. Forty-five percent of U.S. adults do not drink
any alcohol at all.15 Abstention is an important option. Fewer Americans
consume alcohol today as compared to 50 to 100 years ago.

The hazards of heavy alcohol consumption are well known and include
increased risk of liver cirrhosis, hypertension, cancers of the upper
gastrointestinal tract, injury, violence, and death. Moreover, certain
individuals who are more susceptible to the harmful effects of alcohol should
not drink at all. In addition, alcohol should be avoided by those
participating in activities that require attention, skill, and/or
coordination.

Alcohol may have beneficial effects when consumed in moderation. The lowest
all-cause mortality occurs at an intake of one to two drinks per day. The
lowest coronary heart disease mortality also occurs at an intake of one to two
drinks per day. Morbidity and mortality are highest among those drinking large
amounts of alcohol.

KEY RECOMMENDATIONS

Those who choose to drink alcoholic beverages should do so sensibly
and in moderationdefined as the consumption of up to one drink per day
for women and up to two drinks per day for men.

Alcoholic beverages should not be consumed by some individuals,
including those who cannot restrict their alcohol intake, women of
childbearing age who may become pregnant, pregnant and lactating women,
children and adolescents, individuals taking medications that can
interact with alcohol, and those with specific medical conditions.

Alcoholic beverages should be avoided by individuals engaging in
activities that require attention, skill, or coordination, such as
driving or operating machinery.

Discussion

Alcoholic beverages supply calories but few essential nutrients (see
table
16). As a result, excessive alcohol consumption makes it difficult to ingest
sufficient nutrients within an individual’s daily calorie allotment and to
maintain a healthy weight. Although the consumption of one to two alcoholic
beverages per day is not associated with macronutrient or micronutrient
deficiencies or with overall dietary quality, heavy drinkers may be at risk of
malnutrition if the calories derived from alcohol are substituted for those in
nutritious foods.

The majority of American adults consume alcohol. Those who do so should
drink alcoholic beverages in moderation. Moderation is defined as the
consumption of up to one drink per day for women and up to two drinks per day
for men. Twelve fluid ounces of regular beer, 5 fluid ounces of wine, or 1.5
fluid ounces of 80-proof distilled spirits count as one drink for purposes of
explaining moderation. This definition of moderation is not intended as an
average over several days but rather as the amount consumed on any single day.

The effect of alcohol consumption varies depending on the amount consumed
and an individual’s characteristics and circumstances. Alcoholic beverages are
harmful when consumed in excess. Excess alcohol consumption alters judgment
and can lead to dependency or addiction and other serious health problems such
as cirrhosis of the liver, inflammation of the pancreas, and damage to the
heart and brain. Even less than heavy consumption of alcohol is associated
with significant risks. Consuming more than one drink per day for women and
two drinks per day for men increases the risk for motor vehicle accidents,
other injuries, high blood pressure, stroke, violence,
some types of cancer, and suicide. Compared with women who do not drink, women
who consume one drink per day appear to have a slightly higher risk of breast
cancer.

Studies suggest adverse effects even at moderate alcohol consumption levels
in specific situations and individuals. Individuals in some situations should
avoid alcoholthose who plan to drive, operate machinery, or take part in
other activities that require attention, skill, or coordination. Some people,
including children and adolescents, women of childbearing age who may become
pregnant, pregnant and lactating women, individuals who cannot restrict
alcohol intake, individuals taking medications that can interact with alcohol,
and individuals with specific medical conditions should not drink at all. Even
moderate drinking during pregnancy may have behavioral or developmental
consequences for the baby. Heavy drinking during pregnancy can produce a range
of behavioral and psychosocial problems, malformation, and mental retardation
in the baby.

Moderate alcohol consumption may have beneficial health effects in some
individuals. In middle-aged and older adults, a daily intake of one to two
alcoholic beverages per day is associated with the lowest all-cause mortality.
More specifically, compared to non-drinkers, adults who consume one to two
alcoholic beverages a day appear to have a lower risk of coronary heart
disease. In contrast, among younger adults alcohol consumption appears to
provide little, if any, health benefit, and alcohol use among young adults is
associated with a higher risk of traumatic injury and death. As noted
previously, a number of strategies reduce the risk of chronic disease,
including a healthful diet, physical activity, avoidance of smoking, and
maintenance of a healthy weight. Furthermore, it is not recommended that
anyone begin drinking or drink more frequently on the basis of health
considerations.

This table is a guide to estimate the caloric intake from various alcoholic
beverages. An example serving volume and the calories in that drink are shown
for beer, wine, and distilled spirits. Higher alcohol content (higher percent
alcohol or higher proof) and mixing alcohol with other beverages, such as
calorically sweetened soft drinks, tonic water, fruit juice, or cream,
increases the amount of calories in the beverage. Alcoholic beverages supply
calories but provide few essential nutrients.

a Source: Agricultural Research Service (ARS)
Nutrient Database for Standard Reference (SR), Release 17. (http://www.nal.usda.gov/fnic/foodcomp/index.html)
Calories are calculated to the nearest whole number per 1 fluid oz.b The total calories and alcohol content
vary depending on the brand.
Moreover, adding mixers to an alcoholic beverage can contribute calories in
addition to the calories from the alcohol itself.